Common Y2K Issues
Major concerns
• Litigation for wrongful injury or death from malfunctioning equipment
• Lack of adequate contingency planning for "foreseeable" events arising from the millennium changeover
• Lost or late receivables due to electronic interface issues between third-party payers and providers
• Operational impact of nonfunctioning equipment such as computers, medical equipment, telephones, and utilities
• Medical and/or business insurance that doesn’t cover Y2K
Expected impact (Any electronic data exchange is suspect, including banking, payroll, supplier relationships, invoicing, fax networks, phone systems, copiers)
• Late or lost reimbursements
• Computers and information systems that crash and won’t reboot
• Lost patient records, accounting systems, and other information system functions
• Support system failures such as elevators, heating, air conditioning, and ventilation equipment
• Probably best compared to the amount of confusion, interruption, and work created by a hurricane or other natural disaster — except it won’t go away as fast
• Much of the impact may be external, in that devices such as traffic lights, power supplies, telephones, and other similar devices may be inoperable
Preparations
• Inventory all computer systems, software, and external interfaces such as telephones, utilities, and suppliers.
• Don’t assume anything is compliant (even Windows 98 has minor Y2K bug problems).
• Check with manufacturers, software providers, and repair companies.
• Verify any "important" suspect functions, both internal and external to the organization.
• Educate personnel on Y2K issues.
• Get involved in contingency planning for any unresolved issues.
• Conduct a risk assessment.
• Record all compliance initiatives (in order to prove due diligence process in court and protect against rework).
How big is your problem?
• The answer is as varied as the number of software providers, manufacturers, suppliers, vendors, support organizations, types of equipment, number of embedded systems, and age or complexity of equipment.
• In some cases, the same model number and year of equipment can vary in Y2K compliance (due to different embedded systems).
• Typically, the older the equipment, the more frequent and complex the Y2K issues.
Codes to be rewritten
• Much of it cannot be done because of fragility of older codes.
• 80% of Y2K problems are written into firmware or embedded systems and cannot be fixed except by replacement of embedded systems or devices.
• Only 1% to 5% of embedded systems are affected, but the affected ones can only be found by testing the total.
HCFA’s role and Medicare
• It appears unlikely that reimbursement issues will be resolved in time, but the extent of delays is difficult to define.
• Anticipate payment delays by analyzing the impact on your organization. The positive side is that payables will likely be delayed as well.
Record-keeping
• Its very nature imparts time, date, and duration-sensitive problems — the three big hits.
• The older the system, the higher the risk, but even new systems frequently fail some Y2K functionality checks.
Expected compliance costs
• This figure depends on organization size. The Gartner Research Group estimates that the average health care organization will spend millions of dollars to become compliant, and contends that most are underestimating the cost by as much as half. The field will likely spend the most long-term when litigation costs are factored into the equation post-millennium.
Source: Audie G. Lewis, director, material program development, Lee Memorial Health System, Fort Myers, FL, and co-author of The Year 2000 Health Care Survival Guide, AHA Press, Chicago.
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